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NPI Code Detail

MEDICARE: CATHERINE A. BOELLNER LISW, MSW

MEDICARE: CATHERINE A. BOELLNER LISW, MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorI.2203678OH
2251S00000XCommunity/Behavioral Health Agency
31041C0700XClinical Social WorkerI.2203678OH

General Provider Information

NPI Number : 1497221428
Entity Type Code : Individual
Provider Name (Legal Business Name) : CATHERINE A. BOELLNER LISW, MSW
Provider Business Mailing Address
First Line : 840 GIBSON DR
Second Line :
City : TOLEDO
State : OH
Zip : 43612-3918
Country : US
Telephone Number : 419-779-5982
Fax Number :
Provider Business Practice Location Address
First Line : 4159 N HOLLAND SYLVANIA RD STE 205
Second Line :
City : TOLEDO
State : OH
Zip : 43623-4801
Country : US
Telephone Number : 419-517-6564
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2018
Last Update Date : 05/22/2023

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